Why on earth we don’t have open source proper terminology servers?

The competition amont different information models in healthcare will never end. Yes, I know that there are many out there who think that a particular piece of work is so much better than the rest, and it is the feature of healthcare informatics. Sorry, I don’t agree. There are many other reasons, which I’d like to outline in another post, but in general, I can’t see this competition going away in the future.

What is interesting is, use of terminologies is common in many information model standards, whether it be HL7, EN 13606 or openEHR. There are many open source tools for many aspects of healthcare informatics, but when it comes to terminology management, the choices are surprisingly few! Other than NCI’s LexGrid initiative and Apelon, I can’t see any serious terminology server work in the open source domain. These two have their own pros and cons, but in general, this sub domain is surprisingly deserted. Please know that I’m not considering projects which were updated 3 years ago for the last time as candidates for my work in Opereffa.

There is huge work around the concepts which will eventually get linked to terminologies, but there is not much effort in the terminology server area. Yes there are many browsers out there, but whatever you do in the modelling phase, you’ll have to have access to a proper terminology server during use of that model (be it a Snomed CT subset or an HL7 message with Snomed CT codes in it). So why I can’t see an interest in this? Is it because people are so focused at well known problems, that they do not bother to think about what lies beyond them? Did open source healthcare attack the problem of informatin model based solutions first, omitting terminology based solutions? Terminology based approaches are old, and they are well established, so I can’t explain the lack of open source decent projects in this field. If you know one, drop me a line, and I’ll buy you a beer/wine/{insert your favorite drink here}.